At our Cosmetic and General Dentistry practice, I hear this question quite often. Patients come to me with crowns, sometimes decades old, asking if they need to be replaced. Frankly, without an evaluation it’s difficult to give one simple answer. I’ve treated patients whose dental crowns have lasted decades with no pain or problems. But the decision to replace an old crown really depends upon a number of factors, and appearance isn’t the only reason to replace an old crown.
Basically, crowns are provided as a restorative option to protect teeth weakened by decay or fracture. Often decay has taken its toll, and a dental filling won’t work because there is not enough natural tooth left to fill. Crowns (also called “caps”) are also useful to restore misshapen, discolored or broken teeth. Procedures like implants, root canaled teeth and teeth that serve as anchors at the ends of a bridge must also have a custom-fitted cap or crown as well. People who grind their teeth or clench their jaws, two very common nighttime activities, will end up with fractures and cracks in their teeth’s enamel and usually require dental crowns more than any other patients I see. In many cases they need to be replaced, sometimes more than once, over the course of a lifetime.
Crowns Fit For Royalty
Perhaps the strongest crown made, is one made from metal. The options include gold, or crowns made from a combination of alloys like nickel, chromium and palladium. For patients that need or want metal crowns on the very back teeth, we typically only use high noble gold since it casts the most accurate and lasts the longest. Indeed I have seen gold restorations that are over 60 years old!
Porcelain is another available option. In the past it was the most popular since the porcelain can be fused to metal so that it will blend in seamlessly with surrounding teeth. In the last 10 years crowns that are made completely of porcelain have been developed that can be color-matched precisely to surrounding teeth and are just about as strong as all gold crowns. We have had great success with custom shaded E-Max, Porcelain fused to Zirconia, and All Zirconia crowns. The point is that there are many options and each situation is unique. I have had a great deal of experience and am able to choose the right crown for the right situation, always with the emphasis on natural cosmetics, fit, strength and longevity.
Real Reasons to Replace an Old Crown
First, and foremost the best reason to replace any crown is if the tooth has decay under the crown. If the gum recedes over time and the exposed root surface develops a cavity, many times we cannot “patch it” with a filling and we have to remove the crown to get the decay out. Sometimes this causes the tooth to need a root canal if the pulp has become infected and this requires either drilling a small hole in the crown to get access for the root canal or removing the crown to treat it and replacing it with a new crown. Sometimes, for instance after bleaching teeth, the crown no longer looks good and we have to remake it for esthetic reasons. And finally, the older type porcelain fused to metal crowns on front teeth will ultimately show a dark shadow at the gum line that is more and more unsightly when the patient ages and their gum recedes. Almost always this can be remedied by replacing it with one of the new generation all porcelain crowns.
Dental crowns can also break or chip. While it’s almost unheard of to see an all-metal crown like gold break, the porcelain component of a porcelain-fused-to-metal crown can fracture. Under these circumstances, it’s imperative that the crown’s seal over the tooth remain intact. But any dental crown that is damaged or broken should definitely be seen by dentist for an evaluation.
Sometimes it’s as simple as a chip, and a quick buffing can remedy the problem. Depending upon the extent of the crown damage, it may need to be replaced and the only person that can make that determination is your dentist.
Overall, the average crown lasts an average of 10 – 15 years however most insurances will cover replacement after 5 years. At our office, we do not do “average” crowns and so it is not unusual for our crowns to last for decades. Think of it like a car. The average car will rarely last 10 years, but many carefully maintained and cared for cars can last for decades. A lot depends on the initial fit and capacity to seal properly, which ultimately depends of the quality of the impression and model , the expertise of the lab, and the skill of the dentist who seats and cements the crown.
At Dr. Mark Langberg, DDS, MAGD, patients can expect a positive experience. We can offer relaxed, pain-free treatments in an anxiety-free, relaxed atmosphere. There are many preventive and cosmetic restorations that are available, and we’re always more than happy to help you select an option you’re most comfortable with. Excellence in dental care has never been this easy or this friendly. Schedule an appointment with us today at 248-356-8790 and see what the latest innovative techniques in modern dentistry can do for your smile!
Until next time,
Mark W Langberg, DDS, MAGD